The condition that Dr. Livingstone and Dr. Conway have diagnosed, divergent strabismus, usually starts in early childhood when the muscles that align the two eyes fail to develop properly.

Although abnormal physical features (dysmorphism) are not common, when they do occur they may include severe growth failure, small head circumference, brachycephaly, flat occiput, prominent metopic suture, intermittent divergent strabismus, small nose with anteverted nostrils, long and smooth philtrum, thin upper lip, and low set ears.